Broad, long-term objective: The broad goal of the Cooperative Multicenter Neonatal Research Network is to contribute to the identification of therapies to reduce infant mortality and morbidity . Specific aim: The specific aims of Wake Forest University School of Medicine (WFUSM) as a participant in the Neonatal Research Network is to enroll patients into clinical trials and offer expertise to the Steering Committee?s efforts to design trials that are clinically relevant and methodically rigorous. These specific aims will be achieved by recruiting subjects from the two neonatal intensive nurseries directed by WFUSM?s Division of Neonatology. These two nurseries contain over 90% of the level ill neonatal intensive care unit beds in a 19-county region in northwest North Carolina. Each year in this region there are approximately 20,000 births, including 1400 who are admitted to the WFUSM neonatal intensive care units, and 270 who are very low birth weight. An important attribute of WFUSM is that it is a regional perinatal and neonatal center which provides care primarily for a geographically-based sample of neonates, with sociodemographic characteristics that resemble those of the US population. Research protocols that include outcomes identifiable after discharge from the hospital will be facilitated by WFUSM?s Infant Follow-up Program, in which developmental and follow-up is provided to all very low birth weight infants discharged from WFUSM?s two neonatal intensive care units. Since 1977, the follow-up rate for very low birth weight infants, through one year corrected age, has always exceeded 80%. WFUSM?s Maternal-Fetal Medicine Section will facilitate clinical protocols requiring prenatal interventions or assessments. The WFUSM Maternal-Fetal Medicine Section is the only provider of tertiary level obstetric services in the geographic region served by the two neonatal intensive care units at WFUSM, and is a site in the NIH-sponsored Maternal Fetal Medicine Multicenter Research Network. The institutional principal investigator for the Neonatal Research Network at WFUSM has a Masters degree in Public Health (Epidemiology) and fourteen years of experience in clinical outcomes research, emphasizing infant developmental outcome. Additional institutional resources include an NIH-sponsored General Clinical Research Center, an outstanding Department of Public Health Sciences, a Genomics center, a full range of pediatric subspecialists, state-ofthe art neonatal and obstetric facilities, and excellent support staff of respiratory therapists, nurses, and research nurses.